Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic
BackgroundHyperphosphatemia poses a significant risk for cardiovascular diseases and mortality in hemodialysis patients. Non-adherence to phosphate binders and a low-phosphate diet behavior contribute to this issue. Leveraging psychological and behavior change theories has proven effective in addres...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1361778/full |
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| author | Arrom Thongsunti Chatchawan Silpakit Thanapoom Rattananupong Wonngarm Kittanamongkolchai Wonngarm Kittanamongkolchai Wonngarm Kittanamongkolchai Warangkana Sumethpimolchai Vitool Lohsoonthorn |
| author_facet | Arrom Thongsunti Chatchawan Silpakit Thanapoom Rattananupong Wonngarm Kittanamongkolchai Wonngarm Kittanamongkolchai Wonngarm Kittanamongkolchai Warangkana Sumethpimolchai Vitool Lohsoonthorn |
| author_sort | Arrom Thongsunti |
| collection | DOAJ |
| description | BackgroundHyperphosphatemia poses a significant risk for cardiovascular diseases and mortality in hemodialysis patients. Non-adherence to phosphate binders and a low-phosphate diet behavior contribute to this issue. Leveraging psychological and behavior change theories has proven effective in addressing many health risks. During the COVID-19 pandemic, face-to-face communication was limited, and telehealth served as a bridge to address healthcare gaps. This study aimed to determine the effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic.MethodA two-arm parallel randomized controlled trial with assessors blinding involved 80 participants who were stratified block-randomized into either the TMT program group (n = 40) or the control group (Usual care; n = 40). Linear regression was used to compare the two groups on serum phosphorus levels, knowledge of hyperphosphatemia management, and dietary consumption behavior at the 24-week endpoint. The readiness to change (stage of change), self-efficacy, and phosphate binder adherence were assessed using Fisher’s test.ResultThe TMT program demonstrated a significant reduction in serum phosphorus levels compared to usual care (mean difference = −1.03, 95% CI = −1.77, −0.29). Additionally, improvement in dietary consumption behavior related to phosphorus-containing foods was also observed (mean difference = 13.48, 95% CI = 8.41, 18.57). Positive effects emerged in the readiness to change (p < 0.001), self-efficacy in the appropriate use of phosphate binders (p = 0.025), and adherence to phosphate binders (p = 0.001) at the 24-week endpoint. However, groups did not differ in knowledge of hyperphosphatemia management (mean difference = 7.02, 95% CI = −1.03, 15.07).ConclusionThe study demonstrated that the TMT program has positive effects on reducing serum phosphorus levels, providing a hyperphosphatemia management strategy for ESRD patients undergoing hemodialysis via telehealth.Clinical trial registrationTCTR20230628003, https://www.thaiclinicaltrials.org. |
| format | Article |
| id | doaj-art-c9ab34352ae148998ccdba133f28d455 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-c9ab34352ae148998ccdba133f28d4552024-11-28T16:16:05ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-11-011210.3389/fpubh.2024.13617781361778Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemicArrom Thongsunti0Chatchawan Silpakit1Thanapoom Rattananupong2Wonngarm Kittanamongkolchai3Wonngarm Kittanamongkolchai4Wonngarm Kittanamongkolchai5Warangkana Sumethpimolchai6Vitool Lohsoonthorn7Health Research and Management Program, Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandDepartment of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandDivision of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandMaha Chakri Sirindhorn Clinical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandRenal Immunology and Transplantation Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandHemodialysis Unit, Dontoom Hospital, Nakhon Pathom, ThailandDepartment of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandBackgroundHyperphosphatemia poses a significant risk for cardiovascular diseases and mortality in hemodialysis patients. Non-adherence to phosphate binders and a low-phosphate diet behavior contribute to this issue. Leveraging psychological and behavior change theories has proven effective in addressing many health risks. During the COVID-19 pandemic, face-to-face communication was limited, and telehealth served as a bridge to address healthcare gaps. This study aimed to determine the effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic.MethodA two-arm parallel randomized controlled trial with assessors blinding involved 80 participants who were stratified block-randomized into either the TMT program group (n = 40) or the control group (Usual care; n = 40). Linear regression was used to compare the two groups on serum phosphorus levels, knowledge of hyperphosphatemia management, and dietary consumption behavior at the 24-week endpoint. The readiness to change (stage of change), self-efficacy, and phosphate binder adherence were assessed using Fisher’s test.ResultThe TMT program demonstrated a significant reduction in serum phosphorus levels compared to usual care (mean difference = −1.03, 95% CI = −1.77, −0.29). Additionally, improvement in dietary consumption behavior related to phosphorus-containing foods was also observed (mean difference = 13.48, 95% CI = 8.41, 18.57). Positive effects emerged in the readiness to change (p < 0.001), self-efficacy in the appropriate use of phosphate binders (p = 0.025), and adherence to phosphate binders (p = 0.001) at the 24-week endpoint. However, groups did not differ in knowledge of hyperphosphatemia management (mean difference = 7.02, 95% CI = −1.03, 15.07).ConclusionThe study demonstrated that the TMT program has positive effects on reducing serum phosphorus levels, providing a hyperphosphatemia management strategy for ESRD patients undergoing hemodialysis via telehealth.Clinical trial registrationTCTR20230628003, https://www.thaiclinicaltrials.org.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1361778/fullhyperphosphatemiatranstheoretical modelmotivational interviewingtelehealthhemodialysis |
| spellingShingle | Arrom Thongsunti Chatchawan Silpakit Thanapoom Rattananupong Wonngarm Kittanamongkolchai Wonngarm Kittanamongkolchai Wonngarm Kittanamongkolchai Warangkana Sumethpimolchai Vitool Lohsoonthorn Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic Frontiers in Public Health hyperphosphatemia transtheoretical model motivational interviewing telehealth hemodialysis |
| title | Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic |
| title_full | Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic |
| title_fullStr | Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic |
| title_full_unstemmed | Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic |
| title_short | Effect of a transtheoretical model-based intervention and motivational interviewing on hyperphosphatemia management via telehealth (TMT program) among hemodialysis patients during the COVID-19 pandemic |
| title_sort | effect of a transtheoretical model based intervention and motivational interviewing on hyperphosphatemia management via telehealth tmt program among hemodialysis patients during the covid 19 pandemic |
| topic | hyperphosphatemia transtheoretical model motivational interviewing telehealth hemodialysis |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1361778/full |
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